Loading...
7500 212TH ST SW (3) 24 pgs_Redacted75700 sr sw Feb 28 17 12.'59a George Paris/George Paris 4255827612 p.2 r CITY OF EDMONDS 'r BUSINESS LICENSE APPLICATION — COMMERCIAL n o Engineering Bmeennp FEE: $125,00 a File CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION Planning I� 121 5T" AVENUE NORTH. EDMONDS- WA 9JI pNnnlF a-25 77F �s�s Police OFFICE USE ONLY EL# Custcrner # SIC u Year 7A t Class SHO Date Paid 3 TR# ob Fee ti> Mailed Deleted INSTRUCTIONS: Please complet,a the application in full and attach the required floor plan. Middle initial or name required of ail parties Concerned. If no middle name, please Indicate by writing NMN. Sign and roturn application with fee, Please advise of any change in status New license required if business changes location or ownership. NDtirrcatlon to City of Edmonds required if business closes. License expires December 31" each year. Renewal must be supmltted prior to January 31"" to avoid late foes. / BUSINESS NAME ('^1F O� ll C Pl'T tKJ('t� S /ki, t'C' J� /� BUS'INESSADORESS _. S�Q 2 S� 7 / Id 6-01-N6/J5 LF/A -'7 ��j nSireet �t .}- ,/ Suite /�Cityy,,SSttaa(a. Zip Code MAILING ADDRESS (�0V (/' -7 / �J' 1i(/ 1 1 y/)/v +s /Street or PO Box # Stine a City, Slate, Zip Code BUSINESSPHONC( i—(4 a t "i 3X57 '' �} �t � WA �. 10 BUSI[JESS E-MAIL __.. �V t r1 S _ Gfe� a- iD/�� > �/ �• [y( INE55 WESSITE � �. G��i , BUSINESS OWNER I MAIN CONTACT - L% t_ �/C— Co IG P/4-k ( 4� it"ol G l3y XTY-1 Name Phone Number / PROPERTY Name EMERGENCY NRTIFICATION (For Premise ACCESS in Emerpeney). _ RA 1121� S Last Marne ., CIA Brno First Name NATURE OF BUSINESS (Provide a OetaBetl Ooecription of Business Activifies, Products & SPAGF ALTERATIONS^ TO BE MADE: YES_NOX DESCRIPTION FRE\'10JS BUSINESS AT THIS ADDRESS f-S (/ /'( ICI i'i' tr l-q C.T NLJMBER OF EMPLOYEES D SOUARE FOOTACE OF BUSINESS SPACE TYPE OF SUSINE3S.-PLtASE CHECK APPROPRIATE CATEaOHY: O CONSTRUCTION C1 FINANCE, INSURANCE, REAL ESTATE LANDSCAPE, HORTICULTURAL u W.NUFACTURING ❑ NON-PROFIT ❑ RETAIL �p SECONDHAND DEALER }� SEKVICES n WFiOLcSAL E ❑ OPHER -123� Phone (4 4J16` LI YI S7, f Phone Number r ifsii 661t; o?-ftl Phone Number PROPOSF-n OPENING DATE: `7 1 1 Ili 1 ,/� BUSINESS HOURS: 8 "' 0 0 2 Z � 0,0 DAYS OPEN: SUNDAY WEINESDAY MONDAY THURSDAY -TUESDA`Yf RIOAY SATURDAY AMUSEMENT DEVICES ON PREMISES? YES _ NO�IF YES, TOTAL NUMBER LIQUOR SOLD ON PREMISES? YES. NO GAMBLING? YES_ NO-2LCIGARETTES SOLD ON PREMISES? YES NO�� FLAMMA.SLE'JR HAZARDOUS MATERigLS USED OR STORED? YES NO IF YES, PLEASE PROVIDE A LIST OF MATERIALS AND QUANTITIES: PARKING SPACES ON SITE TOTAL SRAC ES .� ACCESSIBLE SPACES FOR HANDICAP PARKING____._ DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIBLE TO PERSONS WITH DISABILITIES? eo Printed Name TITI,E !•--t DATE NO Feb 281712:59a George Paris/Geolge Paris 4265827612 P.3 NAME LAST -- FIRST NICOLE IN?IAL AODRESS STREET SUITEIAPrIUN96 CITYISTATEIMP CODE HOME PHONE( nRIVERS LICENSE OR 10 F B STAY KNIFE PARTNERSHIP — PARTNER 1 LAST FIPT MIDDLE INITAL AOORE88 STREET SURENPi/VN6p CITY9lR621P CODE IIOM IVNIONEI OR«LRB UCRNSF OR 10# A STATE DATE OF BIRTH _o"IETATE OF BRTN COUNTRY OF BIRTH PARTNERSHIP —PARTNER 2 NME VAST FIRST MIWIE INITIAL WRE$$ STREET 6UREAPiIUNITO CITY/SIATFYp COOS HOOF. PHONEI_y_ ORNER'SIICENSEORORSSTATE DATE OF BIRTH CFYY/STATEOFSPTX CCIJ R OF SIRVI _ pytPORATIOW LLC or PE NAME OFCPIPORATION ro F/15 OL'e-G- FEOEAALrAXO# coRP.AooR=_ss !BERG si ('Qr"O( xo� bwfto Fl/Yi ww+9'6 f 240) n, 5IF SRM $u14APL 1JnYp CqI SUM dLP Cp.. PIKA. wmly CORPOPnTE OFFICERE: Iii1NM1P OAi P�'S FIN(N. MI TJIe OVVPISM . GrFd�O F- M 4 'SI II7 11RRf 1 TA�i-ir"hLh ow �G/r�� LGCALCOIOTMCT�/W'\S �F/r(�-1 �T 141/j11�• G�DICr` 1}/( Sl�l�i LeN MI TiY. p.YdA1 (ava6s4 �!*sq O P«. uum «ON.F IORISM PNme Numb« CITY ME ONLY: BUILDING DEPT. 0 APPROVE O DISAPPROVE DATE SIGNATURE OCCUPANT LOAO DUILDNB PERMIT OCCUPANCY eecup COMMEND ENGINEERING Q APPROVE Q DSAPPRDVE DATE FIRE DEPT. O APPROVE O DISAPPROVE PATE SIGNATURE SIGNATURE U.F.I.R. CONVENTS PLANNING CEPT. O APPROVE Q UIGAPPROVE DATE YIGNATME 20NNOCODE COM ITIONALUSEPERMIT COMEWS POLCEDEPT. Q APPROVE Q VI PROVE DATE SIGNATURE OOm"fill n Feb 28 17 12:59a George Paris/George Paris Q 42 55827612 p. 4 �.. - ' �' .• .. 'r .,8 i . 1. p•--y>_ .i'�-•- .N.'.. p. s - U, �'T "i rr'F' 7i '•F: roc r r..._v^.;y" I FIRE. PREVENTION P�. Serving Brier, Edmonds, and "I 12425 Meridian Ave S INSPECTION REPORT SDiC HOmIS _CO. ,: F&IT-10; g 1Vlountlake Terrace . Everett, WA 98208 ❑ EDMONDS ❑ BRIER ` Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE IDISTRT ❑UNINCORPORATED WWW.FireDlstrictl.org :Fax (425) 551-1272 F' LOCATION: 7500 212 th Street SW Bldg 98026 " FREQUENCY STATION &SHIFT Annual 16-B 212th Office Building BUSINESS NAME: 4257761234 PHONE: SCHEDULED Dec 2016 ► DATE DUE s` 509 MAILING 2002 196th ST SW, Lynnwood, WA 98036 ADDRESS: UFIR ► , BUSINESS OWNER: '• • HOME PHONE: v✓v1 �- Enterprises ;EMERGENCY-1: HOME PHONE: 4257761234 HOME CURRENT KEY ACCESS-2: HOME PHONE: CITY YES NO BUSINESS-8-- EMAIL: LICENSE PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR:L % f STEMS: FE 3/15 Date Last Serviced: HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS ]r � r "iIF Ta r 1 V (;xf-T. ool VV,cAok c, rs�c,l ('ie r'n ne 1 -} 2 �� ezc.11. (1�.'15� ;`. 1 �jA�,eL+✓� I .C�Sj(�. C'X��' (`IUD G%Dc7r� �'1�j� 'r��r��C c� 2_ . 3 5 % / C 6 / 7 4 r fl r-r I/- ctlz vv,K�- I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION 2nd RE -INSPECTION FINAL RE -INSPECTION EXTENSION VIOLATIONS DATE DUE. DATE DUE. GRANTED T0- GATE DUE: CITED: PERSON PERSON ! PERSON CONTACTED: CONTACTED: CONTACTED: INSPECTOR: INSPECTOR: ? INSPECTOR: 12 DATE: DATE: I DATE ` 3 VIOLATIONS VIOLATIONS CITATION ISSUED PRE -CITATION 1 = 5 . 1 5 _ LETTER SENT NUMBER* 4 CODE _ 5- 2 6 2 6 DATE SECTION- ._. _ .. ....... . ... ..._.. .... ... . RETURN RECEIPT 3 :7 3 7 RECEIVED 6 DISPOSITION. 4 g 4 8 7 DATES LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 SNOHOMrSI FIR Serving Brier, Edmonds, and b` Mountlake Terrace Twww.FireDistrictl.org LOCATION: BuslNEss NAME: 7500 212 th Street SW Bldg 98026 MAILING 212th Office Building ADDRESS: BUSINESS OWNER: 2002 196th ST SW, Lynnwood, WA 98036 EMERGENCY-1: KEY ACCESS-2: EMAIL: PERSON CONTACTED:�� NAME OF INSPECTOR: FIRE PREVENTION` 12425 Meridian Ave S INSPECTION REPORT: s 148EEverett, WA 98208 B ❑BRIERRIER Phone (425) 551--12,00 ❑ MOUNTLAKE TERRACE; ❑UNINCORPORATED;, ;' Fax (425) 551-1272 FREQUENCY STATION & SHIFT PHONE:': SCHEDULED DANnI &III' 16-A 4257761234 uFIR ► Dec 2015 509 HOME PHONE,' HOME PHONE: CURRENT HOME PHONE: CITY YES NO BUSINESS 4257761234 LICENSE 1:1 )�f INITIAL IN PECTIO DATE 2--1 17/I 5' I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION _- - - 2nd RE -INSPECTION FINAL RE EXTENSION -INSPECTION VIOLATIONS DATE DUE: —T DATE DUE: — — GRANTEDTO: DATE DUE: CITED: PERSON ,- PERSON---_-......___ PERSON CONTACTED: CONTACTED: CONTACTED: INSPECTOR: INSPECTOR- INSPECTOR- 2 DATE: — ._......_ _ _ ._._ _._ DATE: _ .. - — =---- DATE: VIOLATIONS VIOLATIONS; ti PRE -CITATION _ CITATION ISSUED 1 15, 1 15 LETTER SENT NUMBER: 4 ,.._...._. ._._. ! I CODE 2 16 ., 2 6 DATE: SECTION: 5 3 € 7 3 17 RETURN RECEIPT RECEIVED 5 .4....._., "..%8®.._ : �... 4 i 8 DATE:.. .......... _.... E. ?.�'.. ..._.._..... _._-_...... .. ? .....:..._... a._.._..._. _ ... ,,.w LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO y ...__... .. . 8 .i V 4 i LOCATION: i� jl BUSINESS NAME: MAILING ADDRESS: BUSINESS OWNER: Ern ai l : j EMERGENCY-1: KEY ACCESS-2: EMAIL: _ PERSON CONTACTED: NAME OF INSPECTOR: FIRE PREVENTION Serving Bhei; Edinohds' 'and' 4 1 ?425 Meridian Ave S ' 'INSPECTION REPORT Mountlake Terrace Everett, WA 98208 ❑ ❑ BRIER S BRIER T1 Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE ❑ UNINCORPORATED ww FireDistrictl.Org Fax (4 25) 551-1272 FREQUENCY STATION & SHIFT 7500 212th Street SW Bldg 98026 ~ Annual16-C 212th Office Building PHONE: 4257761234 SCHEDULED Dec 2013 2002 196th ST SW, Lynnwood. WA 98036 Clay Enterprises FIRE SYSTEMS: FE 3 11 OwL)A)0 U2 HOME PHONE: HOME PHONE: HOME PHONE: DATE DUE - . UFIR / 509 `4` Q I 1 1 Z V4 CURRENT CITY YES NO BUSINESS LICENSE INITIAL INSPECTION DATE 1 C1L/ I HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS �1 1 2 &J / "\ 'D 0 /J ) 2 3 3 4 4 5 ° G 5 Ij 6 6 "N" 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) O THE NEXT 30 DAYS X 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: I INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS 1 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: a 2 6 2 6 DATE: CODE SECTION: 5 3 ° 7 3 7 RETURN RECEIVED RECEIPT 6 4 8 4 8 DATE: DISPOSITION: 7 _ 11 LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 FIRE DEPARTMENT COPY f n� FIRE PREVENTION i v Serving Brier Edmonds 12425 Meridian Ave S INSPECTION REPORT SNOHOMISH CO. FIRE Mountlake Terrace, and Everett, WA 98208 %EDMONDS BRIER DIST the Town of Woodway Phone (425) 551-1200 ❑wOODWAY ❑ TERRACE wwwFireDistrictl.org Fax (425) 551-1272 ❑ UNINCORPORATED FREQUENCY STATION & SHIFT I ` LOCATION: 7500 212th Street11 SW BLGG 365 16 A BUSINESS NAME: 212th Office Bldg PHONE: 4257761234 DATE DUE SCHEDULED► 12101;12 MAILING 2002 196th 'St SW UFIR ► 509 1 �151 ADDRESS: Lynnwood 98036 BUSINESS OWNER: Clay Enterprises HOME PHONE: 4257761234 ACTIVE EMERGENCY-1: Clay, Merl HOME PHONE: 4257761234 CURRENT KEY ACCESS-2: FAX 425-775-9736 HOME PHONE: CITY YES NO BUSINESS LICENSE PERSON CONTACTED: iy INITIAL INSPECTION DATE NAME OF INSPECTOR: 2at'-0, \ G to! - P�-j FIRE FE 1_ SYSTEMS: ANNUAL HAZARDS FOUND AND LOCATI NS / COMMUNICATIONS 1 R% - P► t- 1 aA -2 2 3 i 3 A •,i- n9 4 4 5 - 5 6 6 7 7 .1 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION G9ANT_ ED TO: , FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON- CONTACTED: PERSON CONTACTED: t j INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS 1- 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 4 8 4 8 DATE: DISPOSITION: 7 LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 FIRE DEPARTMENT COPY SNOHOMISH CO. Sei-ving Bi.ief;- Edmonds FIREMountlake Terrace,and -� the Town of''Woodivay www FireDistrictL org ( LOCATION: 7500 2124h Street BUSINESS NAME: 212th Office Bldg 'e MAILING 2002 196th St 13W ADDRESS: Lynnwood BUSINESS OWNER: Clay Enterprises EMERGENCY-1: Clay, Ken KEY ACCESS-2: FAX 425- 75-9736 PERSON CONTACTED: NAME OF INSPECTOR: FIRE aYSTENII S: t FIRE PREVENTION 12425 Mef-idian Ave S INSPECTION REPORT Everett, WA 98208 ❑ BRIEREDMOS ❑BRIER Phone.'(425) 551-1200 , . _; ❑ WOODWAY _. [IMOUNTLAKE TERRACE Fax (425) 551-1272 r ❑ UNINCORPORATED SW BLDO FR3EQUraENCY STATION &SHIFT PHONE: 4257761234 98036 HOME PHONE: 4257761234 HOME PHONE: 4257761234 HOME PHONE: SCHEDULED 12i0m1 DATE DU tE,� UFIR / 4i9 1 e157 ACTIVE CITY RENT YES_,_ NO BUSINESS--r---E] ❑ LICENSE INITIAL INSPECTION DATE ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS 1 � 1 2 2 3 3 4 4 5 5 6 6 - 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS 1 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2 6 2 6 DATE: CODE SECTION: 5 3 7 3 4 7 8 RETURN RECEIPT RECEIVED 6 4 8 DATE: DISPOSITION: LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 FIRE DEPARTMENT COPY r . FIRE PREVENTION CITY OF EDMONDS SAFETY SURVEY ar r 121 5TM AVENUE N. • EDMONDS, WASHINGTON 98020 (425) 771-0215 FIRE DEPARTMENT . ' 41s 9� t 1 8 LOCATION: 2'12th Street � SW BLDG w , BUSINESS NAME: 212th Office Bldg PHONE: 4�776 � 234 MAILING 2002 196th St SW ADDRESS: Lynnwood 98036 BUSINESS OWNER: Clay Enterprises HOME PHONE: 4257761234 Clay, Ken 4257761234 EMERGENCY-1: HOME PHONE: KEY ACCESS-2: FAX 425-775-9736 HOME PHONE: FREQU5E;Z STATI, 6N 8 eIFT SCHEDULED 12,101/10 DATE DUE ► UFIR ► 509 1A 57 ACTIVE PERSON CONTACTED: INITI�fAL INSPECTION DATE NAME OF INSPECTOR: W✓��2 21� I/�I I I Fi `- ' _ I FIRE FE f %L SYSTEMS: ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS r-i ENTER CODE ONLY ONCE ► VIOLATION CODE 1 5 5 6 t` 6 7 7 8 8 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: _ 3 VIOLATIONS 1 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2 6 2 6 DATE: CODE ` SECTION: _ 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 7 4 8 4 8 DATE: DISPOSITION: 8 LETTER NEEDED 7] YES ❑ NO LETTER NEEDED ❑ YES Ej NO FIRE DEPARTMENT COPY ..�..-..:.,ram .. l "3 O O 0 i L S (S? CITY OF EDMONDS BUSINESS LICENSE APPLICATION- COMMERCIAL FEE: $125.00 CITY CLERK'S OFFICE, BUSINESS LICENSE DIVISION ins, 189�� 121 5' AVENUE NORTH, EDMONDS, WA 98020 PHONE: 425.775.2525 OFFICE USE ONLY OOOQRR BL# Customer# C Year C ss SHD Date Paid TR# Fee Pai Mailed Delete —INSTRUCTIONS: Please complete the application in full and attach the required floor plan. Middle initial or name required of all parties concerned. If no middle name, please indicate by writing NMN. Sign and return application with fee. Please advise of any change In status. New license required if business changes location or ownership. Notification to City of Edmonds required If business closes. Gd� cJS-D?„6 BUSINESS NAME 0/y n G OL / ✓G /O -_yea /7 BUSINESS ADDRESS��1 Z� ZJ�' S�i�I•, �Gl�i>� ��� �Q%�� ��lr Street ' �' G�Suite No. Zip Code MAILING ADDRESS OT�j� • rr��// Sheet or PO Box r Suite No. City, State and Zip Code L G�, BUSINESS PHONE NO. ('Tl/7) r — E 6 . WA STATE TAX ID NO. (UBI NO.) ���T ! 'T1 BUSINESS E-MAIL � -- BUSINESS WEBSITE — !/ / 2 PROPERTY OWNER G lij _�irf/ r� piJ�,�i�jr�i j ( 7 Z/ j 7 -yg;am Nime Phone Number EMERGENCY NOTIFICATION (For Premise Access in Emergency): Last Name r First Name OG/ t/vTOl b" Last Name NATURE OF BUSINESS G G /&(' NUMBER OF EMPLOYEES Z SQUARE FOOTAGE OF BUSINESS SPACE 'T S5 TYPE OF BUSINESS - PLEASE CHECK THE APPROPRIATE CATEGORY: -316� O CONSTRUCTION O FINANCE, INSURANCE, REAL ESTATE O LANDSCAPE, HORTICULTURAL O MANUFACTURING O NON-PROFIT O RETAIL O SECONDHAND DEALER ESERVICES Cl WHOLESALE O OTHER AMUSEMENT DEVICES ON PREMISES? O YES F1`N0 IF YES, TOTAL NUMBER '— LIQUOR SOLD ON PREMISES?: O YES 9r'N_O GAMBLING? Cl YES e O CIGARETTES SOLD ON PREMISES? O YES 0<0 FLAMMABLE OR HAZARDOUS MATERIALS USED OR STORED?: O YES QNO IF YES, PLEASE PROVIDE LIST OF MATERIALS AND QUANTITIES: PROPOSED OPENING DAY OF BUSINESS �! 0 BUSINESSHOURS�/I�/% -7 "/W CI DAYS OPEN O SUNDAY 'MONDAY WIUESDAY S'WEDNESDAY Er URSDAY 0 RIDAY IRI TURDAY PARKING SPACES ON SITE: TOTAL_ ACCESSIBLE FOR PERSONS WITHDISABILITIES7 DOES THE BUSINESS CONTAIN AN ENTRANCE ACCESSIBLE TO PERSONS WITH DISABILITIES? 3 YES O NO C PREVIOUS BUSINESS USE AT THIS ADDRESS uc __.___ PARTNERSHIP-PM1NERf VG first MI ADDRESS Bilwl ApLNo.UGINu. CIq,SG4and ZlPCada HOMEPHONENOI t DOL MO. (DRIVERS LICENSE NO) OR OTHER SO NO. DATE OF BIRTH CITY AND STATE OF BIRTH COUNTRY OF BIRTH NGYF PARTNERSHIP -PARTNER] Last FlNI MI ADDRESS Street Apt. No.. Unil No. CKY.SuatesnalzbCoalai HOME PHONE NOU COL NO.(ORIVERS LICENSE NO.) OR OTHER ID NO DATE OF BIRTH CRY AND STATE OFBI0.TH fAIWTRV OF BIRTH NAMEOFCORPORATION CCRP, ADDRESS CORPORATOR FEDERALTAXBTNO. PHONE NO.(_J SIMI CORPORATE OFFICERS' lestNGm SUIta,APL.UWW. QtNSeband Zlp Ooue Flal Name MI Tile DBMMBMN ODLNo. (OdveM LNznee NP.IGdnerb No. LOLALCONTACT (__) lestName Flrst Name W TRe PM1oAe No OOLW.(DmmsUc No IwOIM1erONP. CITYU EONLM PLANNINDDEPT. OAPPRO/E ODISAPPROVE DATE SIGNATURE ZONING CODE CONDITIONAL USE PERMT COMMENTS SUBDINGCEPT. OMPROVE ODISAPPROVE DATE SIGNAWRE OCGUPANTLMD SUILOING PERMIT OLLUPANCYGRWP COMMENTS FURE DEFT. DAPPROVE DORAPPROVE DATE SIGNATURE U.f.I.R. COMMEN B POLICE OEPT. OAPPROVE GDISAPPROVE DATE SIGNATURE COMMENTS Washington State Department of Health By the authority of RCW 18.108 this person Ryong B Oliveto r Secretary is granted a Massage Practitioner License Status ACTIVE Effective Date 02/09/2012 Initial Issuance 01 /2211997 Credential Number MA 00010027 Expiration Date 03/22/2013 Personal Copy of Your Credential Washington State Department of Health By the authority of RCW 18.108 this person Ryong B Oliveto is granted a Massage Practitioner License Status Credential Number ACTIVE MA 00010027 A-.eA, `_ -`- Expiration Date Sec retary 03/22/2013 Law changes Display of Massage Practitioner Licenses The 2011 legislature passed a bill (SHB 1133) amending the law relating to massage therapy. The new law is effective July 22, 2011. It requires: • A massage practitioner's name and license number to appear on all of his or her advertisements; • A massage practitioner to conspicuously display his or her license in his or her principal place of business; and, • A massage practitioner to have a copy of his or her license available for inspection while performing any activities related to massage therapy (if it is not his or her principal place of business). �� SUITE IP.4 � SUITE ]B3 �.' �j+ GGSA�L?Ya �s�?4ci't CL4"�6lil' II 39Rv!CE5 i SW'5' tE?6' !9t.L :BCh' a 698GC. 4 I rl" frill c 201 _�..�� �..:... ..._...._._.s E..:._..` !r i78 i� sJITE 2'' DR ZEND—•,jtl"•. :t*GCR?�Y 1 GSC� "� ic.:T \\\,�; i UI' � _ �� {I 3itlTg a,a � BWTE 70e1. '8i3RE :10 SUITE 771 II il'iE 717 Sl_:ITE 719 ^yZZtx! _44 t XO, A'4 J04N BdJNEISTER JOz+7: 3•ri."E�.9 !!! �F C1:n:!C COS'E'�G SttCJEC:` PLiG t czam-t1G { 1 r _ � _ _ _ !!� _ �C _ Partners 7500 Building Upper Floor «� 5�. 9t� �" ft*&V*ft a. �. , - 5WL,� EDMONDS, WASHINGTON 5G4LE: 3/32'=I'-C' arY C: , Eoraas. cav ± SUITE II CASE E ! �I C I cj1± 1 I I T-w _. FnLgn_CA�^r.Lt>< 1 ��IG + 1c 111 SUITE III!, ± fill SUI GI :O: _...._C`. - �. : 1 1_ VACANT GR SE TTLE U6BG S.S. _ _ Mb3 _ — )!?E IJ r+.EcnoN I in Duzati.� YAv 7 1 � • �J Ii IL/ II I � � I 1 � � � I � ;1 I 'E 1m6 SUITE.k7; I' SUITE Cr8 CFI CENTER VACANT :C�=CEY. a i'C8' I �� � ( I' SUITE 112 i SUITE 113 SUITE 114 SON MILLS DDSj, == ----- WIOLE BODY CHILD NUTRITION DOZY STEINER UELNESS CLINIC tom.. I ! •'==�' -- �j" '-__. - _--_ CLINIC u+CESS 7 1 J- Y r 7500 Building Main Floor EDMONDS, WASHINGTON Partners II\�I SCALE: �G' -4� r' U V LO=ATEC+N; zcD; 4TOS. UaB+=1w TP.. QLTE, lS;J'1r: 5ER 9.:Fiii Oil 13' -11 1/8, SUITE 118 483 S.F. BAE MUSCULAR THERAPY & REHAB. °Suite 1.18 7500 Building LYNNWOOD, WASHINGTON ! T Partners sires Architectural Design Group, Inc. lawiffomsmEEMMroiffMWwAXWaiWA25-Meo FMassMMI PROJECT: 1500 BUILDING LOCATION: EDMONDS, U)ASNINGTON DATE: NOVEMBER 3, 2011 N 8T44'00' W 20000t 7500 Building EDMONDS, WASHINGTON rlmn)m t4 eSY EEIsr.. wb P.•tBtrtw tNT• IEISSIIfMY IYROb Ym IMlmm Mltl WWafMB IImmIB BBQ •. IRUo W B a •, u]EE W ! a s. tt•m awm ••B W t a •n tm t:.t•B Eot olvwl • taoo W an tm er tune.I a•r clrrl •.tam w zn �__ - -vx.•_ em im Timr L. YW tm om tba tm tbtlbq• Tn1otl tartrD o.bm •. taOE •. mm •B )n ].S are tN wlrtrFwrr•tam trD•tP aIWt • taOE w ]e 1N ws.YrywMufbne tN WYMMEIrYIr••C1wC E6uq•lEnp4 t4•tp TlrNt•1 •. tgOS •tam •b) w ]e ]b 11] atb N46bn OYtlIM1 IbNtm b tNm 6)i t �IBrrI 1N W WDr 1nBLM llealtl••IID BtWw04s b V•ID b uNb >a W Ye 1,2e M x N It) 81IS Yt••pnbn BWa••041 S tlEm WI I,a to Bm uw+•I Pqu:•i tDrry •tam •MI a ].a •. mm m ].n • vao e» :n tm BembOlgrEr rot tamal e.rv. etw.N•t>w t>� b tpm •. taab •m am to as b tt•m n) D � Qr m) b trNo w an t.b {V DEb BIM bTYiE1EB ]m WtI•rtY.IwtrD m."- CilmEtb•", • mm •.tam me m)b S ] � n0 P•ir8t1+'atl� E•1MIr CBID•ry •. IaEE 001.6 ] al NJE MII I.' • a tam 6a f aM BlDmbw I 3 t] YIBI•bNEI ItP•ritr Pft— •. IaE •. VIDD mt mt ] ] bH EbI•mD weorr tab: (J aS MC.�sWF4 NIYw BNWNOeu •.t2D a WED )tl m an tij DN we vaewur ea.ras. a uqE Dm ;0 e A ]n the Y.ublr Wureab a INo ab to ,� ) aB rc..t �Ew a. u•m Eo � )n 0 reril n�Nbrow•a Z yiyA'Rt�D r'ire�/N�j �A2�fi r 1 � � Partners ArcNbcbWIkVp&mqklm )anxE ntamBBr Prd7JEGT: T900 BUILDING LOCATION. EDMONDS, WA841MGTON DATE: NOVE"IBER 9, 2012 i A- CITY OF EDMONDS CIVIC CENTER . EDMONDS, WA 98020 • (206) 771-0215 • FAX (206) 771-0208 FIRE DEPARTMENT fn C . 1 S911 Mr. Ken Clay c/o Clay Enterprises 2002 196th Street S.W. Lynnwood, WA 98036 Subj: 7500 212th Office Building Dear Mr. Clay: BARBARA FAHEY MAYOR April 30, 1997 The Fire Department requires that all unapproved parking spaces be removed. Tenants are utilizing parking ".spaces" past the west end of the parking island (212th Street S.W.) which eliminates the ability to access and drive through this lot as designed. Fire Department concern is providing for clear and easy access to your building in case of emergency. Now that additional parking is provided off of 76th Avenue, we ask that you remove the striping for overflow parking in the original lot. Please remove by June 2nd, 1997. Please direct your questions or comments to the Fire Prevention Office, (425) 771-0215. 4� 1 Z 11 S Pn -ro / ijo ��rG GAS 6,J CAL- &0a) y�''^s� Senior Inspector • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan I�o.1890 CITY OF EDMONDS M 141-WFfpAr��MAYEOR J 250 5TH AVENUE NORTH • EDMONDS, WA 98020 • (206) 771-0220 • FAX (206) 77r21j !V -Pp,Py• COMMUNITY SERVICES DEPARTMENT Public Works • Planning • Parks and Recreation • Engineering File # LAND USE COMPLAINT FORM The upper portion of this form is public record and will be photocopied for the public upon reauest. DATE OF COMPLAINT: 6/q 7 SUBJECT OF COMPLAINT: VIOLATION ADDRESS / LOCATION: 75v0 - D. / -t4 S71. F- a) NAME: PHONE: IS ALLEGED VIOLATOR THE ❑ OWNER OR ❑ TENANT OF THE ABOVE PROPERTY? DETAILS OF COMPLAINT: �/ d�/�OC ,Q�•�" jD ��yl ,>r�GC C�i"S Under the provisions of the Public Disclosure Law, RCW 42.17.310 (1) (e), the complainant may indicate a desire for disclosure or nondisclosure of their identity. If nondisclosure is chosen, the bottom portion of this form will not be released to the public. Please note that if this case is filed in court, your name must be u1Jl.1VJt; li' YUU dLV LV VG Q W1111GJJ 111 L11G I.QJG. The City of Edmonds investigates possible violations on a complaint basis only, therefore, the name of the person filing the complaint must be provided. Name (please Print): Address: SU ` 4 /y Phone: 7 7 /- O Zz.v Please check one of the following boxes: ❑ You may disclose my identity if requested. ea-�—Ou may not disclose my identity without my permission. Signature: l Wm Date: 3/ 4/57 • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan I� g90 CITY OF EDMONDS BARBARA FAHEY MAYOR 250 5TH AVENUE NORTH • EDMONDS, WA 98020 • (206) 771-0200 • FAX (206) 771-0208 POLICE DEPARTMENT • A STATE ACCREDITED LAW ENFORCEMENT AGENCY Commercial Security Survey January 20, 1997 Location: 750 0 - yJ� Owner: CLAY ENTERPRISES; 2002 - 196th SW, Lynnwood, WA 98036 Performed by: Robin Heslop, Crime Prevention Officer Glass doors are vulnerable with single cylinder dead bolts, (keyed on one side only), unless fire release levers lock when dead bolts are locked. In consulting with Edmond's Fire Department, they do not recommend double cylinder dead bolts when a single entrance is used by many different tenants. Single cylinder dead bolts should be added to all office doors. Secure the striker plate with 3" screws into the door frame. (Note: On 1-16-97, I spoke with construction employee, Jason, who was adding new doors and dead bolts on that date.) Large, open space, and full size mirrors gave a good visual of the stalls. During the w6rk-week, there is most likely plenty of activity, but consider locking the restrooms on weekends. This is for occupant's safety due to easy accessibility from the street. Both of these glass doors are very vulnerable being concealed from parking lot and street. The east door opens to a mental health agency, and a large apartment complex, (where I noted paths and arson activity in the shrubs.) I recommend solid core wood or metal doors, with fire release bars. While on site, I spoke with Jason about "shaving" the west door to allow it to shut. • Incorporated August 11, 1890 • Sister Cities International — Hekinan, Japan Page II This door is vulnerable due to its complete concealment, the exterior hinges, and the easily removed pins. This can be corrected by removing the middle screw from the three hinge plates; install a 5" screw across from the removed screw, cut the screw head off, and leave 2-3" sticking out; when the door is closed, the long screw will hold the door in place, even if the hinge pins are removed. The.presentmpadlock,on�ahe insideamustF e removed: Itfiis postedasa "Fite Door"u'In addition, add a single cylinder dead bolt, 6- 12" above the door knob. Secure the striker plate with 3" screws. Add a single cylinder dead bolt with the keyed side to the hall, and the turn handle on the side of the stairs. Trim all shrubs; especially the vegetation in the middle of the parking lot that conceals the front entrance; low growing shrubs trim down to a height of 2-3', so no one can hide behind them; taller shrubs and trees should be trimmed 3-4' from the ground. Parking lot is well lit with lamps properly directed. Remind tenants to close their office blinds at night. Visibility of office equipment and employee activity is intensified when it is dark outside, but light inside. Due to the varied use of the building, I would not recommend a traditional alarm system. There is at least one system on the market that offers sound and voice sensors in an effort to detect a "normal user" occupant from a burglar, but false alarm problems can still occur when tenants come into the building after hours and forget to call the security company. If problems continue in the future, we can explore this option. CLAY ENTERPRISES (206) 776-1234 / Fax: (206) 775-9736 2002 196th S.W. Lynnwood, Washington 98036 December 15, 1994 Edmonds Fire Department 250 5th Ave N Edmonds, Wa 98020 RE: 7500 212th Street Office Building Hazards Dear Fire Department, As per your request in a letter dated December 12th, here is a list of all tenants and vacancies in the 7500 Building. 101,102,107,108,109 103 AND 104 105 106 110, 111, 112 113 114 15 116 117 118 201 AND 202 203 AND 204 205 AND 206 207 208 209 210 211 212 AND 213 214 215 AND 216 217 218 MYRUT REAL ESTATE SCHOOL GOLD MINE MORTGAGE KASPAR MECHANICAL DR. STEVEN STOUT OSC VOCATIONAL CHILD NUTRITION, OSPI STEINER NW ENERGY ALLSTATE INSURANCE HAHN AND COMPANY SPEECH REFERRAL NORCROSS CLINIC LEGACY FINANCIAL GJ ISAACSON & ASSOC. VACANT ACS ORTHOTICS SPEECH REFERRAL SEAWOOD HOMES EVERGREEN TEXTILE SHAMROCK GROUP ELIZABETH TAYLOR SMITH GILBERT HONANIE DAN BROWN ENTERPRISES NATIONAL HEALTH CARE INS. If you have any questions please call our office. Sin erel , en Clay Clay Enterprises RECEIVED DEG 1 U 1994 EDMONDS FIRE DEPT. APPENDIX "A" The following table sets forth the criteria referred to in Section 10.10.060 D and by this reference is incor- corporated therein as if.set forth in full. FIRE FLOW (GPM) Item Affecting Flow Not to Required Reauirement Formula Exceed Flow Item 1: Ground area of Building in square feet (A) 1000 + A/1.0 5000 + Item .2: Height in Stories (H) 500 (H-1) 3000 + boa Item 3: Exposure to and from the Building Judgment- 2000 + 50O TOTAL Item 4:. Deduct for fireproof, semi -fireproof con- struction 1/3 (1+2+3) - Item 5: Add for frame con- struction 1/3 (1+2+3) + ' BALANCE Ll V b a b Item 6: Credit for small fuel load 1/3 (1+2+3) Item 7: Credit for automatic Judgment 1000 - TOTAL FIRE FLOW REQUIRED J �� cacao_..-- —_---- im::3=�:::: ::==:C30NU..::HHUM.:::::0::===___=m==-3m====== :::::::::::::__WC__=______=__ N:"CM ._-muccuc E-i'====== i-..__:::::::::::::::::::::..------_____ -_---- 1�44�� 4 444e 4ee44=44445 5==r--------- m r5===_= :s=E?6e=:4e4.ieE444= November 1, 1982 MEMO TO: Hank Lewis Associate Planner FROM: Gary L. McComas Fire Marshal SUBJECT: OFFICE BUILDING FOR MR. LA PIERRE AT 212TH & 76TH AVE. W. After review, the fire department has the following comments: 1. The parking and traffic flow pattern is acceptable to the fire department. 2. Additional comment will be made at the time of review for the building permit. 't"WAR-72VI"'K MR GLM:be